gaihn child health: supporting system integration tim jelleyman, paediatrician, waitemata district...
TRANSCRIPT
GAIHN child health: supporting system integration
Tim Jelleyman, Paediatrician, Waitemata District Health Board / GAIHN child
health clinical lead & Louise McCarthy, GAIHN Child Health Project Manager
April 2013
GAIHN Greater Auckland Integrated Health Network• Partners:
– DHBs: Auckland, Waitemata, Counties Manukau – PHOs: Auckland, East Health Trust, ProCare, Total Healthcare
• Objective: To reduce acute/avoidable hospital admissions.
• Aim: To improve integration between primary and secondary care, and to strengthen the regional capacity of primary care.
• GAIHN’s role: To lead and coordinate collaborative processes to develop initiatives which are then implemented across the region by the partners.
• Four Work Streams: 1. Identify and manage individuals at high risk of hospitalisation2. Improve primary care responses to acute events 3. Enablers of better individual care – pathways, and e-tools (e.g. Shared Care)4. Child health - aligns with Work Streams and Northern Regional Health
Plan
Overview
• GAIHN child health work streamo alignment and areas of focus
• West Auckland Locality Child Health Plano draft priorities and objectives
GAIHN Child Health Work Stream• Aligned: National Better Public Services:
Vulnerable children, Rheumatic Fever, Maternal/Child Regional Northern Regional Health Plan (NRHP) Child Services Plan District DHB Annual Plans
• Current focus (NRHP priorities):o Clinical pathways and decision support tools / resources: skin
infections, lower respiratory tract infections, chronic cough, eczemao Support locality planning for child health: West Aucklando Counties Manukau Health 20,000 Days Campaign: report on
prevention and management of skin infections / cellulitis in the community
• Planning for 2013-14:o Improve enrolment, engagement and interventions for vulnerable children
and pregnant women: focus on two localitieso Support localities and GAIHN partners to implement NRHP prioritieso Prevention and management of skin infections in the community: 20,000
Days Campaign, Otara pilot
West Auckland Locality Child Health Work Stream
• West Auckland locality:o Approx. 242,000 people. 0 – 14 year olds: 23% of the populationo Ethnically diverse: Maori 12%, Pacific 14%, Asian 18%, Other 57%o Approx. 65% of the population live in NZDep 2006 deciles 6-10o Three clusters of practices: New Lynn, Henderson and Masseyo Top four child ASH volumes: gastroenteritis / dehydration, asthma,
cellulitis, respiratory infections
• Development of West Auckland locality child health plan:o Stakeholders: secondary care paediatric and maternity services, GPs, Plunket,
Whanau Ora service, DHB Funding and Planning and locality project manager, GAIHN, PHO liaison
o Process: monthly meetings since November 2012o Current status: draft plan with agreed priorities
Areas proposed by group
• Antenatal, birth, infancy continuum• Rheumatic fever prevention• Skin infection• Asthma
West Auckland Child Health Planpriorities and objectives
Maternal, child health, Well Child Tamariki Ora (WCTO) interfaceo Children at risk: e.g. Te Aka Ora model; information-sharing, coordinationo e-Shared Care planningo Earlier registration with LMC by 12/40; newborn enrolment; risk awareness
linked to social and health interventions
Building service around continuums of life
Rheumatic Fevero Guideline awareness and implementationo School-based throat swabbing in schools (high needs areas)o Community awareness: through Rheumatic Fever programme and local
networks and providers, e.g. Plunket
Population health in the locality
Skin infectionso Clinical practice guidelines awareness and implementationo Locality-based social services engagemento Health literacy for whanau / families o Specialist / paediatric care in locality hub
Increasing capability and capacity where it counts
Asthmao Engage with asthma-related services in the areao Consider systematic use of clinical guidelines and tools e.g. GASP, chronic
care planning templateso Use e-Shared Care Plan for high needs children and familieso Explore establishing of a cluster-based practice nurse forumo Household smoking cessation
Sharing goals, outcome measurements and responsibility
West Auckland child healthnext steps
• Finalise the plan o including detailed activities, roles, timeframes and measures
• Present the plan o to the locality governance group for endorsement
• Test the plano Test in health system settingso Test with decision-makers: GAIHN approval of maternal and child health
objectives and other priority areas such as skin infections
Contact details Dr. Tim Jelleyman, Paediatrician/Head of Department – Paediatrics and Newborn Services, Waitemata District Health BoardDDI: 09 839 0000 Mobile: 021432744 [email protected]
Louise McCarthy, Project Manager Child Health, GAIHNDDI: 09 3697192 Mobile: [email protected]
www.gaihn.health.nz